RESUMOPara avaliar a prevalência de sobrepeso e obesidade em diabéticos tipo 1 (DM1), estudamos 170 pacientes (89F/81M; 14 crianças, 51 adolescentes e 105 adultos, com 24,4±11,9 anos) e correlacionamos seus dados antropométricos com fatores demográficos e clínicos. A prevalência de obesidade, sobrepeso e/ou risco de sobrepeso foi de 21,2% (n= 36). Houve uma correlação de 0,97 entre o score z do IMC e o percentil do IMC (p= 0,00) no grupo de crianças e adolescentes. Houve diferença na PAS (p= 0,004) e na PAD (p= 0,0007) entre pacientes com IMC normal e alterado. Ocorreu uma tendência a um aumento progressivo da medida da cintura com os níveis de PA (p= 0,0000). O IMC foi dependente da idade (OR: 1,04, 95% IC = 1,01-1,07; p= 0,008) na análise multivariada. Na análise stepwise, a PAS foi dependente da cintura (r= 0,57; p= 0,00) e da idade (r= 0,63; p= 0,00) e a PAD, da cintura (r= 0,53; p= 0,00). A prevalência de sobrepeso e obesidade nos DM1 parece refletir a tendência mundial de aumento de peso e suas conseqüências clínicas, reforçando a necessidade do controle de peso nestes pacientes. To evaluate the prevalence of overweight and obesity in type 1 diabetes (DM1), we studied 170 subjects (89F/81M, 14 children, 51 adolescents and 105 adults, mean age 24.4±11.9y) and correlated anthropometric data with demographic and clinical factors. The prevalence of obesity, overweight and/or overweight risk was 21.2% (n= 36). Among children and adolescents BMI z score and BMI percentile were highly correlated (r= 0.97; p= 0.00). SBP (p= 0.004) and DBP (p= 0.0007) were different between patients with normal and high BMI. A trend for increase waist circumference (WC) was observed in the groups with different BP (p= 0.0000). By multivariate analysis BMI was age-dependent (OR: 1.04, 95% CI = 1.01-1.07; p= 0.008). Using stepwise analysis SBP was dependent of WC (r= 0.57; p= 0.00) and age (r= 0.63; p= 0.00) and DBP was dependent of WC (r= 0.53; p= 0.00). The prevalence of overweight and obesity seems to reflect the global tendency of weight excess and their clinical outcomes. Awareness of overweight in DM1 needs to be intensified. A OBESIDADE ESTÁ EMERGINDO rapidamente como epidemia global, provocando grande impacto na saúde pública por estar associada com várias comorbidades endócrinas e metabólicas, incluindo diabetes mellitus tipo 2 (DM2), hipertensão arterial sistêmica (HAS) e dislipidemia (1,2), artigo original

BACKGROUND: An increased prevalence of impaired glucose homeostasis is reported in Turner syndrome. Endothelial changes are described in patients with insulin resistance, which may be present in patients with Turner syndrome. Video capillaroscopy is a noninvasive examination that allows assessment of vascular patency. OBJECTIVE: To describe the nailfold morphology of capillaries in Turner syndrome using video capillaroscopy. METHODS: Subjects were studied in a temperature-controlled room, 20 days after no nailfold manipulations. The capillaries were visualized by microscope connected to a television and computer and were studied and classified according to these patterns: loop distribution, papilla, avascular fields, edema, form, capillary limbs, flow and hemorrhagic extravasation. RESULTS: Fifty patients aged between 6-37 years with Turner syndrome were studied. Eighteen (36%) patients had normal capillaroscopy with hairpin pattern in loop distribution and no avascular fields. The papilla was ratified in 13 (26%) and enlarged in four (8%). Edema occurred in 22 (44%) cases. There were three (6%) macrocapillaries and three (6%) were branched. Tortuosity was present in five (10%) patients. Hemorrhagic extravasation occurred in one (2%) case. Flow was fast in seven (14%), granulous in five (10%) and slow in six (12%). CONCLUSION: There was a high prevalence of nailfold capillaroscopy changes in Turner syndrome and the most prevalent alterations found were edema and ratified papilla.

Women with Turner syndrome (TS) have an increased risk of developing chronic liver disease. The effects of estrogens on liver function remain controversial. Objectives: We evaluated the effects of estrogens on liver function of TS patients receiving conjugated equine estrogens (CEE) and 17␤ percutaneous estradiol (E2P). Patients and Methods: Twenty-three patients with TS were assessed. Evaluation included height and weight measurement, breast development assessment, and laboratory evaluation (aspartate aminotransferase (AST), alanine aminotransferase (ALT), ␥-glutamyl transferase (GGT), and estradiol). Patients were classified into 2 groups: group 1, induced puberty (n ϭ 19) group 2, spontaneous puberty without HRT (n ϭ 4). CEE was prescribed to group 1 for 12 months and after this period they received E2P for 12 months. Medroxyprogesterone acetate was administered orally during the study. All patients were evaluated at baseline and in group 1, again after 12 and 24 months. Results: There was significant gain in height and weight. Rise in estradiol levels was observed at 12 and 24 months with higher levels obtained with CEE use. In group 2, liver enzymes were normal in all patients. In group 1, increased levels of AST and GGT were observed at baseline (n ϭ 2-11% and 5-26%, respectively). During the study, 48% of patients (n ϭ 9) developed abnormal levels of GGT and 26% (n ϭ 5) developed abnormal levels of AST. Conclusions: We found elevated liver enzymes in patients having TS during oral estrogen treatment.

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